Sertraline: Formula, Presentation, Indications, Mechanism of Action, Positive Effects, Doses and Adverse Reactions

It is a natural antidepressant medication, which is usually used in the treatment of depressive symptoms.

With the pressures to which the individual is subjected every day, tend to suffer from different mental problems such as cases of stress disorders, panic attacks or obsessive compulsive disorders .

Chemical formula

  • C17H17Cl2N.
  • Sertraline hydrochloride.

Presentation of sertraline

The presentation of sertraline is in tablets and concentrate (liquid), to be administered orally.

Indications what is it for?

Sertraline is indicated to treat depression , obsessive-compulsive disorders, which are unpleasant thoughts that do not disappear, and the need to repeat some actions arises.

Panic attacks are those that occur suddenly and unexpectedly as an extreme fear and worry about the occurrence of these attacks.

Posttraumatic stress disorder which presents disturbing psychological symptoms that develop after a frightening experience.

The social anxiety disorder is an excessive fear of interacting with others.

This medicine is also used for the treatment of premestrual dysphoric disorder.

Sertraline is also indicated for the treatment of headaches and some sexual problems.

Mechanism of action of sertraline

Serotonin, noradrenaline and dopamine are brain chemicals that begin to fail when stress levels are higher than the levels that the person can handle.

Although the mechanisms of action of these inhibitors are not well known, they are thought to inhibit the reuptake of them in the neuronal membrane.

Sertraline is a class of antidepressants that has its mechanism of action in increasing the amount of serotonin, which helps maintain psychic balance.

The potentiation of serotonin in the central nervous system does not characteristically affect the reuptake of norepinephrine, as in the case of tricyclic antidepressants.

These tricyclic antidepressants have less sedative, cardiovascular and anticholinergic effects than tricyclic antidepressants.

Dose

The administration of Sertraline tablets should be done with food.

In adolescents and adults, the recommended dose from the beginning is 50 mg every 24 hours.

However, to minimize side reactions, treatment can be initiated at a dose of 25 mg.

If it is necessary to increase the dose, it should be done at intervals of a minimum week, applying a dose of 200 mg per day maximum.

In children aged 6 to 12 years, the initial dose should be 25 mg per day.

This dose can be increased to 50 mg a week, taking into account the tolerance of the patient until a maximum dose of 200 mg / day is reached.

Sertraline should be consumed at approximately the same time every day.

When the prescription is for sertraline concentrate, it should be diluted before use.

Mix the concentrate with 4 ounces in 1/2 cup of water, ginger soda, lemon, lime, lemonade or orange juice.

Only the concentrate must be mixed with the indicated liquids and it must be consumed immediately.

The drug usually takes a few weeks or more before patients feel the improvements.

Sudden stopping of treatment can cause withdrawal symptoms such as excessive sweating, mood swings, confusion, nausea, depression, irritability, abnormal excitement, anxieties.

Dizziness, headache, ringing in the ears, tiredness, numbness or tingling in the arms, hands, legs or feet, seizures and difficulty falling asleep.

Adverse reactions

The consumption of sertraline can cause side effects such as:

  • Presence of nausea and dizziness.
  • Intestinal disorders such as diarrhea.
  • Problems of constipation .
  • Presence of vomiting.
  • Difficulty falling asleep or staying asleep
  • Dry mouth.
  • Heartburn.
  • Loss of appetite
  • Modifications in body weight.
  • Excessive fatigue.
  • Headaches.
  • Nervousness.
  • Tremors in the body.
  • Alterations in desire or sexual capacity.
  • Excessive sweating

In case these symptoms are severe or do not disappear, inform your doctor quickly.

Similarly, sertraline causes dependence since the patient gets used to the state of happiness caused by the doses of sertraline that are ingested daily.

Sertraline, positive effects

This medication can improve your mood, sleep, appetite, energy level and can help restore your interest in daily life. It can decrease fear, anxiety, unwanted thoughts and the amount of panic attacks .

It can also reduce the impulse to perform repeated tasks (compulsions such as washing hands, counting and checking things) that interfere with daily life. Sertraline is known as a selective serotonin reuptake inhibitor (SSRI).

Testimony of a user on Drugs.com:

“After being depressed for three years, separating from my girlfriend and moving out of my family’s house, I got worse and worse without motivation, without energy, without sexual desire and could not face getting up and going to work.”

“My life was a mess. I found myself crying most nights and I lost interest in everything I used to enjoy. I finally went to the doctor and received help. ”

“I was prescribed 100 mg of sertraline and the first few weeks were difficult, I was very tired yawning every few minutes, but as the weeks went by, I found myself recovering energy and getting up early, in addition to the sex drive began to return.”

“Now I’m working full time in construction and I feel good again, so please check with your doctor about this medication, it will help you after using it for at least six weeks.”

Warnings and contraindications

Sertraline is contraindicated in patients with a history of allergy or hypersensitivity to both the active ingredient of the medication and any of its components.

The use of sertraline is not recommended in patients with an epileptic history, especially if it is unstable epilepsy.

In case you are receiving electroconvulsive treatment.

If the patient suffers from liver or kidney failure, depending on the condition, the doctor may have to adjust the doses and perform certain tests during treatment.

In case of having low blood sodium levels, or being under treatment with any medication for hypertension , or if you are of advanced age, you should pay special attention.

Since these medications can also alter blood sodium levels.

Sertraline can alter your blood sugar levels, so in diabetic patients it may be necessary to adjust the dose of diabetes medications.

It is not indicated when you have suffered bleeding disorders or if you are being treated with medications that decrease blood clotting such as:

Acetylsalicylic acid or warfarin or another drug that may increase the risk of bleeding.

It is contraindicated in children under six years.

It is not advised in cases of eye disorders, such as glaucoma .

In case of presenting an anomaly in the graph of the heart that is obtained after an electrocardiogram as prolongation of the QT interval.

In the case of diabetic patients, its use should be done with caution, since sertraline can cause changes in glucose levels.

For this reason it is advisable to perform a greater control and monitoring, to avoid hyper or hypoglycaemia.

The use of sertraline is not recommended, as far as pregnancy is concerned, since, although there are no studies in pregnant women, in animals if harmful effects have been demonstrated for the fetus.

Regarding breastfeeding, if there are studies that show that there is sertraline secretion by breast milk and to date, no adverse reactions have been reported in children breastfed by mothers who are being treated with sertraline.

But the risk can not be completely ruled out, therefore, it must be done in those cases where the benefits outweigh the risks.

Interactions of sertraline with other medications

Special care should be taken not to combine this drug with alcohol.

The consumption of antidepressants mixed with drinks containing alcohol can cause serious poisoning in the body.

If alcohol is usually consumed regularly and a treatment based on sertraline is indicated, it is advisable not to consume or decrease the amount of alcohol ingested.

Sertraline can slightly inhibit the action of cytochrome P-450 of the CYP2D6 isoenzyme in vivo, responsible for synthesizing most drugs, which in turn inhibits the metabolism of a certain number of them.

Medicines whose concentrations can be increased by disturbing this metabolic pathway, are antipsychotics such as haloperidol and phenothiazines.

Sertraline increases serotonin levels since it inhibits its neuronal recapture.

In addition, the action of the enzyme monoamine oxidase inhibits serotonin.

Adverse reactions include symptoms such as confusion, severe hypertension crisis and other symptoms of lesser severity.

Amphetamine and dextroamphetamine, on the other hand, stimulate the release of serotonin in the central nervous system.

It also interacts with selective inhibitors of serotonin reuptake, being able to induce an excess of serotonin and also cause the syndrome.

Sertraline may also potentiate the pharmacodynamic effects of warfarin.

In some studies when sertraline and warfarin were administered concomitantly, a significant increase in prothrombin time was caused.

The mechanism of this interaction over prothrombin time is still uncertain and prothrombin time should be closely monitored when treatment with sertraline has begun or stopped.

There are studies with placebo, where the concomitant administration of sertraline with lithium is shown does not modify its pharmacokinetics.

However, an increase in tremor was caused, compared with the placebo application individually, indicating that a pharmacodynamic interaction is possible.

When the interaction of alcohol and other central nervous system depressants was studied, it was found that the simultaneous administration of 200 mg per day of sertraline did not increase the effects that alcohol could have.

The consumption of valerian should be avoided, since it can increase depressive crises at the level of the central nervous system.